Brian J. Hall, MD

Francisco G. Bravo, MD

Mycetoma of the right foot from a patient stationed in Guam demonstrates several draining sinus tracts image (present for months) with tissue swelling and slight hyperpigmentation. (Courtesy J. Steger, MD.)

Although usually more deep-seated, characteristic pale grains of eumycetoma image are seen surrounded by inflammation. (Courtesy S. Florell, MD.)



  • Madura foot, maduromycosis


  • Localized chronic granulomatous infection involving skin, subcutaneous tissue, and occasionally underlying soft tissue and bone; can be caused by either fungi or bacteria


Infectious Agents

  • Most common causal organisms are either true fungi from class Eumycetes (eumycetomas) or filamentous bacteria from class Actinobacteria (actinomycetomas)

    • In eumycetomas, most common causal agent worldwide is Madurella mycetomatis, although many other species can cause disease

      • In the USA, Pseudallescheria boydii is most common agent

    • In actinomycetomas, Nocardia brasiliensis and Actinomadura madurae are 2 most common isolates



  • Incidence

    • Unknown due to slow progression and late presentation in most patients

  • Age

    • Most infections occur in patients aged 20-40 years

  • Gender

    • M:F ˜ 4:1

  • Ethnicity

    • Most cases occur in tropical and subtropical populations

    • “Mycetoma belt” includes areas between latitudes 15° south and 30° north

      • Includes India, Mexico, Venezuela, Colombia, Argentina, Sudan Somalia, and Senegal

    • Occasional case report in USA and Europe

    • People involved with fieldwork &/or frequent contact with soil (herdsmen, farmers, field laborers) are more commonly affected


  • Feet most common location (˜ 70%)

    • Other common sites include hands, legs, knee joints, arms

  • Actinomycetomas of shoulder are commonly seen in Mexico, especially in lumber workers carrying logs


Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Mycetoma

Full access? Get Clinical Tree

Get Clinical Tree app for offline access